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• � N " <br /> � '. U.Frm� 15003-I-1]C.P. � <br /> GITY OF E1'ERETT-=Water Department <br /> A�plication for Water <br /> All blanks must be fiiled in nr crosscd out <br /> Everel�.- .___"____"_"7� �� _'.191�'a <br /> _ _!.__.'__' <br /> TO THE SUPIiRINT1iYU8N7'OF THIi�VA7'F,R UIiPARTM1tENT, , <br /> l'17'1'OF E`IERETT: <br /> I hereby apply(or the use nf water in accordance wilh the rules and rrguln� � <br /> tions nf Thc Wate-Uzpartmrnt, (nr purposcs and fixmres stntcd belnv�. <br /> During the time thal anc of thc�valer mains m���be Inken up by rrason o( <br /> nny impmvemenle authurized by the Citp n( Evcrctt,in or n( any stmrt o� allcy in <br /> which they may have been laid,ihe Cily�cill nn.bc required to lurni^h water during <br /> Ihe pmgress of nuCh imprnvemrnts tn any ronsumer �ehose supply may thus 6e cut <br /> nff,or be liable(ur any dnm;iges for ils failure so to do. <br /> AppliCs[inn No.""__�'Z�'z-_"' <br /> Block ' _'_'_'_ "___.i.oL"_"'_____'__'Add�-� <br /> ,�+���- �� ---�c4'2_�-._�/`7._.. sc«<i <br /> ------�---�-.� . _U�LA.�-d-S�Q�o-�rv--�--------------�----- <br /> 'Pheworklobeexccutedby_.___._.._.___ . _...__ Piumber <br /> _.___...___.__. <br /> State size u(tnp. ' <br /> .1,.�__.Tnp lo be inuurted in the main. / "/�-Z 6 <br /> _"__'__Wntcr doscl <br /> _______IlaUi <br /> ._..-___ .Urinal <br /> ____'_.___Plain fanmt insidr <br /> ..___""Side wnik wnshrr <br /> .____...Hnsc EiL octsidc <br /> "_"'-_'Hos'c bib fnrbuilcling purpnsca • <br /> ."'_....Hnsc bib insidc <br /> .'"""""iii6furs1a61econlaininK ------_.sl�ll_"""" <br /> '___...__.Nnmber of prrsans in (amil�. <br /> _________Ncmbcr o(rnoms in building <br /> 7'hc premiscs are lu be used as n____..___..'_'_.."'_.___"_____'_'_ ', <br /> __'-. <br /> The urvner o(lhc premises is _""_"__"_"_'._'_'_""'_'__""_"'.. <br /> 'fhe aKent is ._____ _-. - <br /> ___"" ......___..__'____..___ <br /> This applicatioe,alt!muµh siqned,shall �mt be binding upnn the Ciq�, until ac <br /> cepted by Thc Superimendenl oflhe \Vnter DeparUnen[. <br /> / <br /> Signed_i�L�'_' � �: ,� . . -. <br /> -__"""'.__.."'_�"'""'_"Applicant <br /> AccepteA . _ . ."_"_"_'191 � 14y._'...."._"_'_"_ <br /> '� � Sn:erintenLem � <br /> ��< < ,.� rs�; o � <br />